Falls are common in the geriatric and older adult population, often causing significant morbidity or mortality. The geometry of the human body in motion requires a highly functional individual to remain balanced and upright under a variety of conditions and perturbations. Balance in this population is adversely affected by intrinsic and extrinsic factors. Medications' therapeutic and side effects frequently contribute to falls. An aggressive approach to falls reduction, including eliminating balance-altering medication, obtaining sub-specialty and balance evaluations when warranted, and requesting home safety assessments is advocated in this review of the current concepts and literature.